Traditionally breast cancer surgery was done as in-patient procedure due to concerns of drain care, post-operative pain,nausea,vomiting and lack of structured post-operative out patient care . Breast cancer surgery isa low risk procedure, this combined with advances in anaesthesia and a seamlessly organisedperi-operative management makes breast cancer surgery in selected optimised patients amenable to daycare – a paradigm shift in the Indian as well as global scenario.

Retrospective study of 40 patients who underwent modified radical mastectomy(MRM)and MRM with sentinel lymph node biopsy with or without drain placement from February 2014 upto September 2014at our institute.Institute’s patient selection criteria followed.Pre-operative evaluation and optimization of patients done..Admissions were on the morning of the surgery. Standard pre-induction, intra and post-operative monitors used. Anaesthetic management –GA with induced hypotension.Multimodal analgesic strategy.Strict criteria forPACU management and discharge planning had been applied by professional team. Time to dischargepost surgery~10-12hours. Feedback documents and follow up records reviewed. Cost implications studied.

Discharges as day case, with drain insitu,was successful in all patients studied. Drain insitucaused no major post-discharge issues. Post-operative pain ,nausea and vomiting scores showed excellent control.Nosocomial infections nil.Readmissions none . Quality of recovery unaffected.Patients satisfaction and psychological well- being high.Cost effective and greater health care efficiency.

Breast cancer surgery as day case should be the goal and eventually the norm. An integrated approach involving meticulous patient selection ,optimization , pre-operative counselling ,qualitative peri-operative surgical,anaesthesia and pain services combined with a structured post-operative out patient care facilityensures safe and successful out come in daycare breast cancer surgeries with high patient satisfaction.